Assessing Outcome in Cognitive Behavior Therapy for Child Depression: An Illustrative Case Series

Recent meta-analytic data suggest a need for ongoing evaluation of treatments for youth depression. The present article calls attention to a number of issues relevant to the empirical evaluation of if and how cognitive behavior therapy for child depression works. A case series of 6 children and a primary caregiver received treatment—individual CBT for the child and behavioral parent training involving the caregiver and caregiver–child dyad. The effects were generally promising and illustrate how selection of inclusion criteria, measures, measurement intervals, and informants can alter conclusions. These areas warrant attention in studies of child depression and are important not only in interpreting treatment outcome data but also for conducting sound clinical practice.     

Parent–child interaction therapy (PCIT) in young children with autism spectrum disorder

Abstract

Parent–child interaction therapy (PCIT) is an evidence-based treatment for typically developing children with disruptive behavior. We conducted a randomized-controlled trial of PCIT versus wait-list control (WLC) with 23 children with ASD (3–7?years) and disruptive behavior. Over 16 treatment sessions, PCIT significantly predicted reductions in disruptive behavior over WLC and explained a significant variation in scores on the ECBI Intensity subscale. Additionally, parent skills improved significantly compared to WLC. However, no statistically significant group differences were found on child compliance rates, autism severity, or parental stress. Results support PCIT as an evidence-based treatment for disruptive behavior in ASD.

• Highlights

• Parent skills were significantly improved for those receiving PCIT

• Intensity of disruptive behaviors decreased significantly for those receiving PCIT

• Parental stress and autism severity did not significantly decrease with PCIT

     

Time-Out Training Without Put-Backs,Spanks, or Restraint: A Brief Report of Deferred Time-Out

We demonstrate the effectiveness of a procedure to increase compliance in young children who are resistant to Time-out (TO). Parents of two boys, 3 and 4 years of age, were unable to enforce TO without resorting to physical guidance and restraint. With deferred TO (DTO), if a child resists TO, caregivers no longer interact with the child or provide the child with tangibles or activities that the child cannot access independently. When the child requests a preferred item or activity from the caregiver that cannot be obtained independently, the child must first serve TO. Once TO is served, the caregiver may fulfill the child's request. Data suggest that DTO reduces the latency between the parental TO command and compliance with TO without put-backs, spanks, or restraint.     

A Family Systems Approach to Behavioral Training with Parents of Autistic Children

This paper reviews briefly the use of behavioral procedures and parent training techniques with parents of autistic children. Potential hazards that may arise when the clinician fails to be sensitive to the family context are examined. Behavioral clinicians are urged to undertake behavioral parent training from a family systems context and thereby enhance the likelihood of more enduring changes for the autistic child and the family as a whole. Case illustrations are provided.     

Parental Positive Reinforcement With Deviant Children:

The purpose of this paper is to review data on the effectiveness of parental positive reinforcement with deviant children. Three areas are reviewed: Non-intervention studies, intervention studies, and consumer satisfaction studies. Results from the first two areas suggest that parental positive reinforcement is neither a necessary nor sufficient procedure to produce or maintain changes in deviant behavior. Results from the consumer satisfaction area indiciate that positive reinforcement is viewed by parents as being both an acceptable and a useful procedure. Therapist recognition of the limitations of positive reinforcement is stressed.     

The Prevention of Children's Maladaptive Fears

The authors address the prophylactic value of behavioral techniques in relation to children's maladaptive fears. The major settings of interest from the viewpoint of preventing children's maladaptive fears are the home, school and health-care settings. Encouraging findings have been reported in the use of film-modeling with children about to undergo dental treatment, tonsillectomies, injections, etc. Several theoretical explanations (stimulus pre-exposure, reciprocal inhibition, reinforcement contingencies, self-efficacy) of the success of such interventions can be advanced to affect the outcome of maladaptive fear prevention programs.     

Behavioral Treatment of Self-Choking in a Developmentally Normal Child

ABSTRACT

In the past, self-choking behavior has been associated with individuals who were either developmentally disabled or experienced psychosis symptoms, and has usually been treated with aversive procedures. A time-series design using several different non-aversive behavioral procedures was used to analyze these treatment effects on an 11-year-old girl whose habit of self-choking interfered with normal functioning. Habit reversal procedures, which implement an incompatible response in place of the target behavior, did not, as first hypothesized, have a positive effect on self-choking behavior. However, attention from a male therapist as a positive reinforcer initially decreased the frequency of self-chokes and percent of time spent self-choking. Attention contingent on performance was not as effective on the child's behavior as attention administered noncontingently. Overall, the behavioral treatment approach applied here does not appear to reduce the target behavior in a clinically significant manner. Implications for future treatment approaches for this behavior are discussed.     

Intergenerational occupational transmission: Do offspring walk in the footsteps of mom or dad,or both?

The purpose of this research was to apply the Theory of Planned Behavior (TPB) in order to investigate intergenerational occupational transmission between parents and their children. A sample of 260 undergraduate students completed a questionnaire measuring TPB variables, and congruence was calculated between the parents' occupations and their offspring's chosen profession. Intention to work in the parents' occupations was predicted by attitude, subjective norm and perceived behavioral control. Congruence between parents' and their children's occupational choice was predicted by intention and perceived behavioral control. The findings provide support to the relational approach in career choice. Implications of the findings for career counselors and young people's career choices are discussed.     

Change detection inflates confidence on a subsequent recognition task

A face viewed under good encoding conditions is more likely to be remembered than a face viewed under poor encoding conditions. In four experiments we investigated how encoding conditions affected confidence in recognising faces from line-ups. Participants performed a change detection task followed by a recognition task and then rated how confident they were in their recognition accuracy. In the first two experiments the same faces were repeated across trials. In the final two experiments novel faces were used on each trial. Target-present and target-absent line-ups were utilised. In each experiment participants had greater recognition confidence after change detection than after change blindness. The finding that change detection inflates confidence, even for inaccurate recognitions, indicates recognition certainty can be a product of perceived encoding conditions rather than authentic memory strength.     

Older adults catch up to younger adults on a learning and memory task that involves collaborative social interaction

Learning and memory abilities tend to decline as people age. The current study examines the question of whether a learning situation that emphasises collaborative social interaction might help older persons overcome age-related learning and memory changes and thus perform similarly to younger persons. Younger and Older participants (n = 34 in each group) completed the Barrier Task (BT), a game-like social interaction where partners work together to develop labels for a set of abstract tangrams. Participants were also administered standard clinical neuropsychological measures of memory, on which the Older group showed expected inferiority to the Younger group. On the BT, the Older group performed less well than the Younger group early on, but as the task progressed, the performance of the Older group caught up and became statistically indistinguishable from that of the Younger group. These results can be taken to suggest that a learning milieu characterised by collaborative social interaction can attenuate some of the typical memory disadvantages associated with being older.